Provider Demographics
NPI:1407306707
Name:NEW BEGINNINGS EATING DISORDERS CENTER, LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS EATING DISORDERS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:HULL
Authorized Official - Last Name:KUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-407-6278
Mailing Address - Street 1:23215 COMMERCE PARK
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5803
Mailing Address - Country:US
Mailing Address - Phone:216-407-6278
Mailing Address - Fax:216-647-0613
Practice Address - Street 1:3610 W MARKET ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-9301
Practice Address - Country:US
Practice Address - Phone:216-407-6278
Practice Address - Fax:216-647-0613
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HULL INSTITUTE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health